Skip to main content

CHAMPS Research Study: U.S. Frontline Nurses Exhibited More Traumatic Stress and Depressive Symptoms than Global Counterparts

Researchers urge implementation of strategies to reduce harmful effects of prolonged frontline service

In one of the first reports of the well-being of hospital-based registered nurses (RNs) in the United States early in the COVID-19 pandemic, scientists from the Villanova University Fitzpatrick College of Nursing national COVID-19 Caring About Health for All Study (CHAMPS), indicate that these frontline nurses experienced more anxiety, depression, stress and insomnia compared to healthcare workers worldwide in two meta-analyses. The paper, Psychological Responses of Hospital-Based Nurses Working During the COVID-19 Pandemic in the United States: An Observational Study, was published in Applied Nursing Research and released online October 27.

The results amplify previous concerns for clinician well-being that predated the global crisis. The authors caution that because the country is 18 months past the initial disaster phase of the pandemic, the stress is no longer acute and they urge turning attention to “mitigation strategies needed to save a workforce that has been under fire for a protracted length of time” and caring for providers with new interventions to improve well-being of those on the frontlines.

The study sample was mostly female (92%) and white (91%); 69% were under the age of 45 years. Ninety-three percent served in direct patient care with 26% identifying their primary work as taking place on a COVID-19 designated unit and another 26% identifying their primary site as the intensive care unit.

The paper includes several key points about the psychological health of the nurses, including:

·       Data suggest that RNs working in U.S. hospitals were significantly more distressed on all well-being measures during the acute phase of the COVID-19 pandemic.

·       Nurses exhibited over twice the rates of trauma and nearly double the rates of depressive symptoms compared with reports from hospital workers globally during the acute phase of the COVID-19 pandemic.

·       Rates of severe depression found in the CHAMPS sample were 4 times greater than rates found in nurses working in China surveyed during a similar period of COVID-19 growth and more than double the rates found in the general U.S. population during the same period.

As the researchers note, “the lasting effects of this distress are unknown and warrant ongoing evaluation and solutions to better support emotional well-being and prevent burnout in the workplace.”

CHAMPS, launched in May 2020, studied health care, first responder and service workers for the health care system during the COVID-19 pandemic to understand the immediate effects, as well as the long-term effects on their health, lives, and careers and to inform future planning and policy for emergency preparedness. Participants were recruited throughout the United States and its territories.


Mensinger JL, Brom HM, Havens DS, Costello A, D’Annunzio C, Durning JD, Bradley PK, Copel L, Maldonado L, Smeltzer SC, Yost J, Kaufmann PG.  Psychological Responses of Hospital-Based Nurses Working During the COVID-19 Pandemic in the United States: An Observational Study.  Applied Nursing Research.  Available online 27 October 2021